The Hangzhou metropolitan area is home to more than 21 million people, making it the fifth most populous metro in China. Sir Run Run Shaw Hospital has two locations and serves about 2.6 million patients annually (double Mayo Clinic).

Sir Run Run Shaw Hospital uses a model of care that "incorporates the best of Chinese and western health care management practices," according to a Mayo news release.

In a statement, the hospital's leader said he was looking forward to collaborating with "Mayo Clinic, a top-tier leader in medicine."

"We expect this relationship to take Sir Run Run Shaw Hospital’s health care and international collaboration to a new level," said Dr. Cai Xiujun, president of Sir Run Run Shaw Hospital.

Mayo's Care Network — not to be confused with its regional system of clinics and hospitals — gives member hospitals access to Mayo resources. Under the agreements, members remain independent, but can connect with Mayo specialists for consultations and access the Rochester-based medical provider's extensive database of research information and educational materials.

Mayo Clinic launched the Care Network in 2011, one year after then-President Barack Obama signed the Affordable Care Act into law. It hopes to use the network to reach as many as 200 million people directly or indirectly by 2020. The Star Tribune (and this is worth a read) has described the network model as "an ambitious effort by the Rochester-based health system to expand its reach and secure its place in an era of rapid changes in health care."

For patients at partnering hospitals, the report says, "the arrangement means access to some of the finest medical specialists in the world. For Mayo, the network is an opportunity to expand its footprint without having to build or acquire new hospitals. It also gets to market its world renowned expertise to patients — many with the most complex cases — who might not otherwise travel to Mayo clinics in Minnesota, Florida or Arizona."

Mayo now has more than 40 members, stretching from here in the U.S. to Singapore, the United Arab Emirates, and elsewhere.

With the addition of a Chinese hospital to its Care Network, Mayo aims to increase its reach into the world's most populous country. Already, hundreds of Chinese visitors make Mayo part of their annual travel plans — and the clinic is banking on the prospect that the agreement with Sir Run Run Shaw Hospital positions them well to compete for medical tourism dollars.

"Medical care is just one manifestation of China’s wide wealth disparity. A new generation of affluent Chinese can seek help at private hospitals or go abroad, even as the rest endure long waits and find their treatment falling short."

The report cites a study from a Chinese booking company estimating that Chinese people took 500,000 outbound medical trips in 2016, a five-fold increase from the year before.

“China is among the countries where we have seen the greatest growth in recent years,” said Dr. Stephanie L. Hines, chairwoman of executive health and international medicine at Mayo Clinic.

Of the more than 1.3 million patients treated each year at Mayo, about 2 percent travel from outside the U.S. and Canada.